IBCRHBS6 ;ALB/ARH - RATES: UPLOAD (RC 2+) CALCULATIONS SETUP ; 10-OCT-03 ;;2.0;INTEGRATED BILLING;**245**;21-MAR-94 ;;Per VHA Directive 10-93-142, this routine should not be modified. ; INPT(IBSITE,IBXRF1) ; Create Charge Sets for Inpatient and SNF Charges N IBRG,IBDIVN,IBEVNT,IBBS,TYPE W !,$P(IBSITE,U,2)," ",$P(IBSITE,U,3)," - Inpatient and SNF Charges" ; ; set billing region S IBRG=$$RG^IBCRHU2("RC "_$P(IBSITE,U,2)_" - "_$P(IBSITE,U,3),$P(IBSITE,U,2),$P(IBSITE,U,4),$P(IBSITE,U,5)) S IBRG=$P(IBRG,U,2),IBDIVN=$P(IBSITE,U,2) ; S TYPE=$P(IBSITE,U,5) Q:TYPE'=1 ; ; ; Inpatient Facility Per Diem Charges from Table A (DRG Based) S IBEVNT="INPATIENT DRG",IBBS="GENERAL MEDICAL CARE" ; Inpatient Standard DRG Charges D SETUP(IBXRF1,"Inpt PD R&B","RC-INPT R&B","RC INPATIENT FACILITY",IBDIVN,4,IBEVNT,IBRG,"INST",101,IBBS) D SETUP(IBXRF1,"Inpt PD Anc","RC-INPT ANC","RC INPATIENT FACILITY",IBDIVN,4,IBEVNT,IBRG,"INST",240,IBBS) ; S IBEVNT="INPATIENT DRG",IBBS="ICU" ; Inpatient ICU DRG Charges D SETUP(IBXRF1,"Inpt PD R&B ICU","RC-INPT R&B ICU","RC INPATIENT FACILITY",IBDIVN,4,IBEVNT,IBRG,"INST",200,IBBS) D SETUP(IBXRF1,"Inpt PD Anc ICU","RC-INPT ANC ICU","RC INPATIENT FACILITY",IBDIVN,4,IBEVNT,IBRG,"INST",240,IBBS) ; S IBEVNT="INPATIENT BEDSECTION STAY",IBBS="SKILLED NURSING/SUB-ACUTE CARE" ; Inpatient SNF Charges D SETUP(IBXRF1,"SNF PD INC","RC-SNF INC","RC FACILITY PER DIEM",IBDIVN,1,IBEVNT,IBRG,"INST",101,IBBS) ; ; ; Inpatient Facility Charges from Table B (CPT Based) S IBEVNT="PROCEDURE",IBBS="GENERAL MEDICAL CARE" ; Inpatient Facility Charges D SETUP(IBXRF1,"Inpt Fac 1","RC-INPT FAC PR","RC FACILITY PR",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS) D SETUP(IBXRF1,"Inpt Fac 2","RC-INPT FAC HR","RC FACILITY HR",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS) D SETUP(IBXRF1,"Inpt Fac 4","RC-INPT FAC ML","RC FACILITY ML",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS) ; S IBEVNT="PROCEDURE",IBBS="SKILLED NURSING/SUB-ACUTE CARE" ; SNF Facility Charges D SETUP(IBXRF1,"SNF Fac 1","RC-SNF FAC PR","RC FACILITY PR",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS) D SETUP(IBXRF1,"SNF Fac 2","RC-SNF FAC HR","RC FACILITY HR",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS) D SETUP(IBXRF1,"SNF Fac 4","RC-SNF FAC ML","RC FACILITY ML",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS) ; ; ; Inpatient Facility Charges from Table C (CPT Based) S IBEVNT="PROCEDURE",IBBS="GENERAL MEDICAL CARE" ; Inpatient Facility CPT Charges D SETUP(IBXRF1,"Inpt Fac/Phys 1","RC-INPT FAC PR","RC FACILITY PR",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS) ; S IBEVNT="PROCEDURE",IBBS="SKILLED NURSING/SUB-ACUTE CARE" ; SNF Facility CPT Charges D SETUP(IBXRF1,"SNF Fac/Phys 1","RC-SNF FAC PR","RC FACILITY PR",IBDIVN,2,IBEVNT,IBRG,"INST",240,IBBS) ; ; ; Inpatient Physician Charges from Table C (CPT Based) S IBEVNT="PROCEDURE",IBBS="GENERAL MEDICAL CARE" ; Inpatient Professional CPT Charges D SETUP(IBXRF1,"Inpt Phys 1","RC-PHYSICIAN INPT PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",960,IBBS) D SETUP(IBXRF1,"Inpt Phys 3","RC-PHYSICIAN INPT MN","RC PHYSICIAN MN",IBDIVN,2,IBEVNT,IBRG,"PROF",960,IBBS) ; S IBEVNT="PROCEDURE",IBBS="SKILLED NURSING/SUB-ACUTE CARE" ; SNF Professional CPT Charges D SETUP(IBXRF1,"SNF Phys 1","RC-PHYSICIAN SNF PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",960,IBBS) D SETUP(IBXRF1,"SNF Phys 3","RC-PHYSICIAN SNF MN","RC PHYSICIAN MN",IBDIVN,2,IBEVNT,IBRG,"PROF",960,IBBS) ; Q ; ; OPT(IBSITE,IBXRF1) ; Create Charge Sets for Outpatient Facilities (CPT based and Partial Hospitalization) N IBRG,IBDIVN,IBEVNT,IBBS,TYPE W !,$P(IBSITE,U,2)," ",$P(IBSITE,U,3)," - Outpatient Charges" ; ; set billing region S IBRG=$$RG^IBCRHU2("RC "_$P(IBSITE,U,2)_" - "_$P(IBSITE,U,3),$P(IBSITE,U,2),$P(IBSITE,U,4),$P(IBSITE,U,5)) S IBRG=$P(IBRG,U,2),IBDIVN=$P(IBSITE,U,2) ; S TYPE=$P(IBSITE,U,5) Q:TYPE'<3 ; ; ; Outpatient Facility Charges from Table B (CPT Based) S IBEVNT="PROCEDURE",IBBS="OUTPATIENT VISIT" ; Outpatient Facility CPT Charges D SETUP(IBXRF1,"Opt Fac 1","RC-OPT FAC PR","RC FACILITY PR",IBDIVN,2,IBEVNT,IBRG,"INST",510,IBBS) D SETUP(IBXRF1,"Opt Fac 2","RC-OPT FAC HR","RC FACILITY HR",IBDIVN,2,IBEVNT,IBRG,"INST",510,IBBS) D SETUP(IBXRF1,"Opt Fac 4","RC-OPT FAC ML","RC FACILITY ML",IBDIVN,2,IBEVNT,IBRG,"INST",510,IBBS) ; S IBEVNT="UNASSOCIATED",IBBS="PARTIAL HOSPITALIZATION" ; Partial Hospitalization Facility Per Diem Charge D SETUP(IBXRF1,"Opt PD PHosp","RC-OPT MISC","RC MISCELLANEOUS",IBDIVN,9,IBEVNT,IBRG,"INST",912,IBBS) ; ; ; Outpatient Facility Charges from Table C (CPT Based) S IBEVNT="PROCEDURE",IBBS="OUTPATIENT VISIT" ; Outpatient Facility CPT Charges D SETUP(IBXRF1,"Opt Fac/Phys 1","RC-OPT FAC PR","RC FACILITY PR",IBDIVN,2,IBEVNT,IBRG,"INST",510,IBBS) ; ; ; Outpatient Physician Charges from Table C (CPT Based) S IBEVNT="PROCEDURE",IBBS="OUTPATIENT VISIT" ; Outpatient Professional CPT Charges D SETUP(IBXRF1,"Opt Phys 1","RC-PHYSICIAN OPT PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS) D SETUP(IBXRF1,"Opt Phys 3","RC-PHYSICIAN OPT MN","RC PHYSICIAN MN",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS) ; Q ; ; FREE(IBSITE,IBXRF1) ; Create Charge Sets for Freestanding Facilities N IBRG,IBDIVN,IBEVNT,IBBS,TYPE W !,$P(IBSITE,U,2)," ",$P(IBSITE,U,3)," - Freestanding Charges" ; ; set billing region S IBRG=$$RG^IBCRHU2("RC "_$P(IBSITE,U,2)_" - "_$P(IBSITE,U,3),$P(IBSITE,U,2),$P(IBSITE,U,4),$P(IBSITE,U,5)) S IBRG=$P(IBRG,U,2),IBDIVN=$P(IBSITE,U,2) ; S TYPE=$P(IBSITE,U,5) Q:TYPE'=3 ; ; ; Freestanding Physician Charges from Table C (CPT Based) S IBEVNT="PROCEDURE",IBBS="OUTPATIENT VISIT" ; Freestanding Professional CPT Charges D SETUP(IBXRF1,"FS Phys 1","RC-PHYSICIAN FS PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS) D SETUP(IBXRF1,"FS Phys 3","RC-PHYSICIAN FS MN","RC PHYSICIAN MN",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS) ; ; ; Freestanding Physician Charges from Table B (CPT Based) S IBEVNT="PROCEDURE",IBBS="OUTPATIENT VISIT" ; Freestanding Professional CPT Charges D SETUP(IBXRF1,"FS Phys/Opt 1","RC-PHYSICIAN FS PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS) D SETUP(IBXRF1,"FS Phys/Opt 4","RC-PHYSICIAN FS ML","RC PHYSICIAN ML",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS) D SETUP(IBXRF1,"FS Phys/Opt TC 1","RC-PHYSICIAN FS PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS) ; ; ; Freestanding Physician Global Charges from Table C (CPT Based, sum of TC and 26) S IBEVNT="PROCEDURE",IBBS="OUTPATIENT VISIT" ; Freestanding Professional CPT Charges D SETUP(IBXRF1,"FS Phys/Add 00 1","RC-PHYSICIAN FS PR","RC PHYSICIAN PR",IBDIVN,2,IBEVNT,IBRG,"PROF",510,IBBS) ; Q ; ; SETUP(IBXRF1,IBXRF2,CSNM,BRATE,DIVN,BITEM,EVNT,RG,CHGTYP,RVCD,BS) ; Set up XTMP array and Charge Set for Charges N IBCS ; S IBCS=$$CS^IBCRHU2(CSNM_" "_DIVN,BRATE,EVNT,RG,CHGTYP,RVCD,BS) ; D SETHDR(IBXRF1,IBXRF2,IBCS,BITEM) ; Q ; SETHDR(IBXRF1,IBXRF2,CS,BITYPE) ; set up header for XTMP file N IBX S IBX="IB Upload RC v"_$$VERSION^IBCRHBRV_" "_$P(IBXRF1,"UPLOAD RC ",2)_", "_$P($$HTE^XLFDT($H,2),":",1,2)_" by "_$P($G(^VA(200,+$G(DUZ),0)),U,1) S ^XTMP(IBXRF1,0)=$$FMADD^XLFDT(DT,2)_U_DT_U_IBX ; S ^XTMP(IBXRF1,IBXRF2)=0_U_$G(BITYPE)_U_$G(CS) Q